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Development of a tool to identify and assess psychosocial and spiritual needs in end-of-life patients: The ENP-E scale

Published online by Cambridge University Press:  16 October 2018

Dolors Mateo-Ortega
Affiliation:
The “Qualy” Observatory, WHO Collaborating Centre for Public Health Palliative Care Programs, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain Palliative Care, University of Vic-Central University of Catalonia, Vic, Spain Research Group on Stress and Health, Faculty of Psychology, Autonomous University of Barcelona, Bellatera, Spain Palliative Care Unit, Consorci Sanitari de Terrassa, Terrassa, Spain
Joaquín T. Limonero
Affiliation:
Research Group on Stress and Health, Faculty of Psychology, Autonomous University of Barcelona, Bellatera, Spain
Jorge Maté-Méndez
Affiliation:
Research Group on Stress and Health, Faculty of Psychology, Autonomous University of Barcelona, Bellatera, Spain Psychoncology Unit, Catalan Institute of Oncology L'Hospitalet de Llobregat, Spain
Elba Beas
Affiliation:
The “Qualy” Observatory, WHO Collaborating Centre for Public Health Palliative Care Programs, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
Jesús González-Barboteo
Affiliation:
Palliative Care Unit, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
Elisabeth Barbero
Affiliation:
Social Work Unit, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
Sara Ela
Affiliation:
The “Qualy” Observatory, WHO Collaborating Centre for Public Health Palliative Care Programs, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
Xavier Gómez-Batiste
Affiliation:
The “Qualy” Observatory, WHO Collaborating Centre for Public Health Palliative Care Programs, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain Palliative Care, University of Vic-Central University of Catalonia, Vic, Spain
Corresponding
E-mail address:

Abstract

Objective

The goal of this study is to describe the development of a new tool, the Psychosocial and Spiritual Needs Evaluation scale Instrumento de Evaluación de Necesidades Psicosociales y Espirituales del Enfermo al Final de Vida (ENP-E), designed to assess the psychosocial needs of end-of-life (EOL) patients. And, secondarily, to describe the face validity and psychometric properties of this instrument in the Spanish-speaking context.

Method

The scale was developed through a seven-stage process: (1) literature review; (2) expert panel establishment; (3) discussion and agreement on the most relevant dimensions of psychosocial care; (4) description of key indicators and consensus-based questions to evaluate such dimensions; (5) assessment of the scale by external palliative care (PC) professionals; (6) evaluation by patients; and (7) analysis of scale's psychometrics properties. To assess content validity, 30 PC professionals and 20 patients evaluated the questionnaire. To determine psychometric properties, 150 participants completed these scales: the ENP-E; the Hospital Anxiety and Depression Scale; item 15 from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative; and the Distress Thermometer.

Result

All respondents evaluated the tool as “excellent.” In terms of construct validity, the internal consistency (Cronbach's alpha = 0.74) and temporal stability (test-retest r = 0.74, p < 0.1) were both adequate. On the factorial analysis, four factors (emotional-wellbeing, social support, spiritual, and information) explained 58.4% of the variance. This scale has a sensitivity of 76.3%, specificity of 78.9%, and the cutoff is 28.

Significance of results

To provide quality PC to EOL patients, it is essential to determine the psychosocial factors that influence well-being. This requires the use of reliable and specific instruments. The ENP-E is a novel tool that provides a systematic, holistic assessment of the psychosocial needs of EOL patients. Its routine use would allow clinicians to monitor such needs over time. This would, in turn, permit comprehensive, highly individualized interventions to improve effective PC approach.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2018 

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